BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ACORN 180 RH

    MDR report key: 6187380 · Received December 19, 2016

    Report

    Report Number
    3003124453-2016-00008
    Event Type
    Injury
    Date Received
    December 19, 2016
    Date of Event
    November 5, 2016
    Report Date
    December 9, 2016
    Manufacturer
    ACORN STAIRLIFTS, INC.
    Product Code
    PCD
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER CAREGIVERS

    Narratives

    Additional Manufacturer Narrative · 1

    CLIENT HAS POLIO AND WEARS A LEG BRACE ON LEFT LEG WHICH WAS BROKEN IN FALL. CAREGIVER REMINDED TO TELL USER TO WEAR SEATBELT AT ALL TIMES WHEN USING LIFT AND TO HAVE ASSISTANCE WITH USE. TECHNICIAN DAMAGED OSG DURING REPAIR, SO NEW OSG FITTED. LIFT REPAIRED AND OPERATING TO SPEC.

    Description of Event or Problem · 1

    UPON DESCENT, LIFT STOPPED AT LANDING. CLIENT TRIED TO GET OFF LIFT AND FELL DOWN TWO STEPS AND BROKE HER LEFT LEG ON WHICH SHE WEARS A BRACE DUE TO POLIO.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    837741 ACORN 180 RH STAIRWAY CHAIRLIFT, PCD ACORN STAIRLIFTS, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 78 YR Hospitalization LEG BRACE